Table 1. Pressures Cited by Practices by Year

The State of Cancer Care in America: 2014, American Society of Clinical Oncology.

The future of privately owed oncology practices in the nation’s cancer care system is growing increasingly fragile amid mounting financial pressures, even as more new patients are seeking help, according to the American Society of Clinical Oncology (ASCO).

Those developments were described in a wide-ranging report, which ASCO called a landmark examination of the challenges facing the system. In unveiling the report, ASCO leaders also called on Congress to improve the payment structure for services provided to Medicare beneficiaries.

To assess the impact of these challenges on oncology practices, ASCO surveyed oncology practices for the second consecutive year. The findings include:

•Consolidation is continuing at a rapid pace—The proportion of practices reporting 7 or more physicians grew from 29% in 2012 to 42% in 2013, while those reporting 6 or fewer doctors in their practice dropped from 71% to 58%.

•The number of new patients is rising—Oncology practices overall reported an average of 1620 new patients last year, up 28% from 2012. Practices with 1 or 2 physicians saw an average of 387 new patients, those with 3 to 6 doctors averaged 1227 new patients, and those with 7 or more doctors averaged 2700 new patients.

•The smallest practices are facing the greatest pressures—More than half of the practices with 1 to 2 physicians responding to the survey said they are likely to merge, sell, or close during this year, a sharp increase from the number that reported similar plans in the 2012 survey (Table 2).

•Health information technology (HIT) is not helping physicians—73% of physicians said the adoption of HIT has resulted in little or no progress in managing the cost of healthcare, and 66% saw little or no progress in increasing their efficiency or saving time for doctors.

•Electronic health record (EHR) systems widely adopted—68% of practices have advanced EHR or medical record systems, while 18% have basic systems. Only 5% of practices do not use such systems.

In all, more than 25% of the estimated 2000 oncology practices in the United States participated in the 2013 survey, with 530 practices representing 8011 physicians responding, according to ASCO. The response rate suggests that the findings do not include enough information about smaller practices, the report noted. In addition, the report cautions that future census rounds must be completed before reported developments can be considered trends. http://goo.gl/Bv6JMe